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DEATH
CERTIFICATE
J. S. ASHLEY
Date 06 March 1920
Cert: 09907
Place of Death: Voting Precinct: Slade, Powell Co., Ky.
Full Name: J. S. ASHLEY
Sex, Color or Race, Marital Status: Male, White, Married
Date of Birth: don't know
Age: 68 years
Occupation: (blank)
Birthplace: Knot Co., Ky.
Name of Father: Will ASHLEY
Birthplace Father: don't know
Maiden name of Mother: don't know
Birthplace Mother: don't know
Informant/Address: Will H. ASHLEY, Winchester, Ky.
Filed: 06 March 1920
Registrar: Guy M. Crowe
Death Date: 06 March 1920
I hereby certify that I attended deceased from 22 February
1920, to
06 March 1920, that I last saw him alive on 02 March 1920, and
that death occurred, on the date stated above, at 5 a.m.
Cause of Death: This man had tuberculosis in (illegible
?chronic?) form
Duration:
Contributory: (blank)
Signed/Address: J. E. Lanning, M.D., Stanton, Ky.
Length of residence where disease contracted: (blank)
Former or usual residence: (blank)
Place of Burial or Removal: (blank)
Date of Burial: (blank)
Undertaker/Address: (blank)
Transcribed by Debbie Tamborski, 06 March 2010 |
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